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Whether it’s hand wringing over the hyper-pressured college application process, anguish about cyber-bullying and social media addiction, complaints about intolerance in the political discourse, or horror over increasing suicide rates among young people, we all are noticing rising levels of perfectionism and its toxic effects. Now, a ground-breaking study is backing up our impressions with hard data – perfectionism as measured among young adults has risen dramatically over the past three decades. Not only does this study provide a context for the increasing demand for mental health services we are seeing at Access Institute, but points to a response that needs to emphasize early, preventive mental health interventions coupled with real help addressing the social environment.

The study, authored by Thomas Curran and Andrew Hill and published recently in a major psychology journal, analyzed the responses from 41,641 college students on a psychological measure called the Multidimensional Perfectionism Scale. The measure has been given to students across several decades in the US, Canada, and the UK, providing the researchers with a robust, longitudinal sample. The scale’s three dimensions of perfectionism are: 1) Self-oriented perfectionism- striving to attain perfection and avoid failure, 2) Socially-prescribed perfectionism- perceiving excessive and unfair demands of perfection from parents, peers and the social world and 3) Other-oriented perfectionism: setting unrealistic standards for others and treating them with hostility and distain when they fail to meet them.

Over the years, studies have linked all three dimensions of perfectionism to psychopathology. For example, self-oriented perfectionism has been linked to increased depression, anorexia, and suicidal ideation. Other-oriented perfectionism is associated with increased hostility, tendency to blame others for one’s own mistakes, decreased trust, and lower sexual satisfaction. Socially-prescribed perfection is the most debilitating of the three and is associated with greater increases in major mental illness, including depression, anxiety, and suicidal behavior. Given these effects, the outcome of the study should give everyone great pause. Between 1989 and 2016, self-oriented perfectionism scores increased by 10 percent, other-oriented perfectionism increased by 16 percent, and most worrisome, socially-prescribed perfectionism increased by an incredible 32 percent.

This change helps to explain what we’ve been seeing in terms of rising rates of depression and suicide among teens and young adults. College counseling centers have reported an epidemic of mental illness on campus. In a 2016 survey of students by the American College Health Association, 52.7 percent of students surveyed reported feeling that things were hopeless and 39.1 percent reported feeling so depressed that it was difficult to function for some of the past 12 months. Not surprisingly, the suicide rate has risen faster in the past 10 years for teens and young adults than for any other age group. As Time magazine reported in its 2016 cover story, “Teen Depression and Anxiety: Why the Kids Are Not Alright”, increases in depression and anxiety among teens and young adults cuts across all demographic groups. It’s not just the college bound kids who are suffering.

While it’s easy to blame the prevalence of social media or changes in the economy, those explanations only scratch the surface. Curran and Hill look more broadly at changes in larger culture as the source for the increases in perfectionism and all their negative outcomes. They cite the rise in neoliberal culture in the US and Europe over the last 30 years and its emphasis on competitive individualism (market-based competition, meritocracy) and a corresponding erosion of collective values and institutions (unions, churches, social safety nets). This new ethos emphasizes personal achievement, upward social comparison, and materialism and devalues collective efforts, recognition of limits, and humanistic pursuits. All of this, they argue, has been well assimilated by the youth of the current era, as seen in their unwavering drive to be perfect themselves and achieve the ideal life.

The authors also note that parents have been playing the supportive role by providing an ever hovering presence in children’s lives and increasing their focus on education and achievement to the detriment of time spent on play, hobbies and leisure. Since the 1980’s, youth report increased parenting practices associated with monitoring and surveillance such as young people needing to tell their parents where they are and what they are doing and they report that supportive behaviors, such as parents showing an interest in their ideas or activities have waned.

The authors of this study are not alone in sounding the alarm about the dangers of succumbing to the social pressure to lead the perfect life. Alexandra Schwartz, writing in the New Yorker, chronicles the growing number of thinkers critiquing the self-help movement, all of them coming to similar ironic conclusions: The drive to improve the self leads to the diminishment of the self which motivates ever more frantic and futile efforts toward self-improvement.

These larger trends also help us understand what we are seeing on the ground here in San Francisco with the children, teens and adults who seek psychological support through Access Institute’s programs. Here in the Bay Area, ground zero for economic inequality and a frayed social safety net, the meritocratic and individualized culture leaves no room for error. Society’s achievement ladder creates ever higher expectations of material and social reward, but it’s a ladder you advance up and the lower rungs fall away. If you slip down it, not only do you have no-one to blame but yourself, but the supports you once relied on are gone. Many Access Institute patients are ether teetering on that ladder and stuck, unable to make choices about career and relationships, paralyzed by the anxiety that they might not get it right, or they’ve actually fallen off. They have lost jobs, become isolated from meaningful connections and have sunk into depression and self-blame. We also see it in the elementary school children we serve where the demands to perform in class start early and there is precious little space for children’s emotional lives, especially if they are messy and demanding.​This all means that we need to redouble our efforts. We need to ensure access to mental health treatment early, before problems related to perfectionism become entrenched and the associated pathologies become acute. The therapy we provide helps people take a hard look at their expectations for themselves, know where they come from, and assess their negative effects. They can learn how to set limits, develop more balanced approaches to life’s difficulties and find meaningful connections. We also need to enhance our programs so we can better help the people who have fallen and help them find the real ladder rungs they need to get back to a stable foundation. That means helping people connect to social resources and staying by their side as they work to find creative solutions to real world challenges related to work, housing, health and community.